Translating settings from AS 11 to AC 10

[dwedward]

I've been having troubles with Flow Limitations for quite some time; to the point where it disturbs my sleep and makes the night unrestful.  My sleep Dr had recommended an ENT to see if there were any issues to be concerned about in my upper airways.  The ENT then recommended a titration with a bipap as he felt there were no issues he could identify, and felt the pressure support would make a difference.

Although I'm waiting for my health insurance to decide whether or not they agree with a titration, I had a chance to purchase a lightly used AC10 Vauto for what amounted to almost a steal! :-)  So, anyway, I thought I would try the bipap to see if there are any differences.  I think I know in general what settings to put as I've used an ST before and learned about IPAP, EPAP, trigger sensitivity, etc... BUT I thought I'd reach out to the community to see if they had suggestions of where to start.

My AS 11 is currently set to auto range between 15 and 20, with no EPR.

My charts from SLHQ are : https://sleephq.com/public/089eb48e-ae49...a7f813d8c7.

This is a typical night for me.  Low AHI but frequent awakenings, as well as minimal deep sleep.  It's really the deep sleep I'm chasing as I can feel the difference between a night of sleep if I get more than 60 minutes of deep sleep.  The next day, I awaken much more refreshed.

Any help you can give would me more than appreciated.  I'll report back on the experiment.

[Gideon]

Set EPR=3, Fulltime on your AS11
EpR= 3 is the same a PS=3
And a night of that will provide insight into BiLevel settings.

Do give your VAuto a factory reset, I'm assuming it is not in the box new, and you want to start with everything at default prior to applying your settings

[Gideon]

I'd appreciate it if you used OSCAR

[SarcasticDave94]

FWIW once you set your machine yourself through trial and error, this makes a titration unnecessary unless you're wanting proof for insurance to pay up. Usage of this VAuto may be enough depending on if docs supportive or resistive.

[dwedward]

Thanks Gideon!  I appreciate your response!  And a good idea on resetting the AC10.

As for using EPR, I did use to have EPR set to 3.  However, if anything EPR made the Flow Limitations slightly worse.  After discussion with my sleep Dr, we eliminated EPR, and increased minimum pressure to 15 (previously 13) based on where my pressures were averaging at the time.

I know that EPR is a standard response for reducing FL as I see it on the board often.  However, in my case it didn't seem to do much.

And Dave, I understand your point.  I guess my expectation is that the insurance company will say no, and we'll go through a long drawn out process to "prove" i need the titration.  Since the unit was a good price, I figured it's easier for me to do this as a trial than to wait....

[Gideon]

The typical reason for getting a BiLevel is for the PS, differential pressure.

[SarcasticDave94]

No, that's fine. I understand it's often much easier to buy the machine yourself. Insurance preventing patients from the correct therapy needed is all too common here, even with myself.

[Gideon]

Let's see what is going on. I use OSCAR, not SHQ. And please provide a 3-minute view of your troublesome areas. 1. SJQ does not play well on my phone, and as a member of the OSCAR team.......

[dwedward]

Hi Gideon,

Thank you for your support.  I used to use OSCAR but my work PC shut down the SD Card port due to security issues.  I do have another PC somewhere in my office credenza.  I'll dig it out, and upload the SD card data to get the same report as on SHQ.  I appreciate your help.

When I read you response earlier I didn't twig on your comment about EPS and PS being the same, hence why I wrote back about EPS on the AS11 not helping.  But I don't think it's exactly the same is it?  I thought PS was additive whereas EPS is subtractive.  Were I to reconfig the AS11, then I'd have to compensate pressure to 18 so I get what I get now.  BTW, the flow limitations seem to be on inspiration, not expiration.

At any rate, I have the AC10 machine now, and am awaiting a new hose and water chamber today (some things I don't trust to disinfectant alone!).  I'll pop in an SD card tonight when I try to get the new data.

Thanks once again for your help!

[SarcasticDave94]

If you're meaning EPR (exhale pressure relief), that is similar to PS (pressure support). Yes, in the VAuto, PS adds to the EPAP (exhale positive airway pressure). PS in VAuto can be set from 0-10, in .2 cmH2O increments.

If it were your AutoSet, EPR will reduce pressure on exhale, it's limited to a maximum of 3 cmH2O, and only has 3 pressure selections.

Below is an image, showing VAuto mode settings and ranges.